Disease Information
How is the treatment approach for tennis elbow (lateral epicondylitis) determined?
In this article
What is lateral epicondylitis?
Lateral epicondylitis is a condition in which pain occurs due to irritation of the wrist extensor tendon attached to the outer side of the elbow caused by repetitive use. It can also commonly occur not only during racket sports but also during computer work, cooking, cleaning, or jobs involving repetitive lifting of objects.
A characteristic feature is that pain tends to worsen gradually as repetitive movements accumulate, rather than starting suddenly.
Common Symptoms
When lifting a cup or bag, opening a bottle cap, or wringing out a towel, you may experience pain on the outer side of your elbow and feel that your grip strength has weakened. It is characteristic that pain is reproduced when pressing on the outer side of the elbow or extending the wrist against resistance.
If symptoms persist for a long time, pain may occur even during simple movements such as lifting light objects.
Cases that need to be distinguished from other causes
If finger tingling or reduced hand strength is also present, nerve problems around the neck or wrist should be checked as well as elbow tendon problems. If swelling and deformity occur after trauma, first confirm whether a fracture is present.
If the joint is red and hot and accompanied by high fever, other causes such as infection must be ruled out.
Evaluation and Examination
We confirm the patient's occupation, repetitive movements, and the time when pain began. We examine elbow and wrist movement, where pain is reproduced during resisted movements, and grip strength.
If symptoms are chronic or accompanied by neurological signs, additional evaluation including the neck and wrist, or imaging studies may be considered.
Treatment Options
When there are no warning signs and management of connected movements in the elbow, wrist, and shoulder along with tendon tension is needed, Chuna manual therapy and acupuncture combined with pharmacopuncture can be considered.
Adjusting the number of repetitions of movements that cause pain and the method of tool use, and gradually restoring wrist muscle strength and endurance from low intensity once pain stabilizes may help prevent recurrence.
Frequently Asked Questions
Does lateral epicondylitis heal on its own?
In mild cases, improvement may occur with activity modification alone; however, continued repetitive use can lead to chronicity, so management is necessary.
Does wearing a brace help?
It may help reduce strain from specific activities, but it does not replace the need to adjust fundamental repetitive usage.
Is injection therapy needed?
In most cases, it is not necessary. Although steroid injections can reduce pain for a few weeks, there is research showing that outcomes after 1 year were poorer compared to cases where injections were not received, and recurrences were frequent. It can be treated with wrist and elbow usage regulation, muscle strength recovery, Chuna manual therapy, and acupuncture and pharmacopuncture.
References & Clinical Guidelines
This page is compiled referencing peer-reviewed literature and clinical guidelines. External links connect directly to the respective publishers.
- Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: a randomized controlled trialCoombes BK, Bisset L, Brooks P, Khan A, Vicenzino BJAMA · 2013 · 309(5):461-9
- Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trialBisset L, Beller E, Jull G, Brooks P, Darnell R, Vicenzino BBMJ · 2006 · 333(7575):939
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Online healthcare content is informational and does not replace medical consultation. Clinical diagnosis and treatment indications are determined by licensed Korean medicine doctors.